Conservatives For Obamneycare

Until Obamacare, mandatory private health insurance was considered the free-market alternative to the Democrats' piecemeal socialization of the entire medical industry. In November 2004, for example, libertarian Ronald Bailey praised mandated private health insurance in Reason magazine, saying that it "could preserve and extend the advantages of a free market with a minimal amount of coercion." A leading conservative think tank, The Heritage Foundation, helped design Romneycare, and its health care analyst, Bob Moffit, flew to Boston for the bill signing.

Of course, Coulter then pretends that Obamacare is nothing like Romneycare, despite the fact that its core provisions are almost identical, and inspired, in part, by exactly the same conservative think-tank ideas. Frum cheers Coulter's "public step toward a more humane and rational vision of conservatism." Philip Klein pushes back:

[P]eople don’t compare Romneycare and Obamacare because their nicknames share the same basic structure, but because the laws have the same basic structure. Specifically, both laws expand Medicaid, force individuals to purchase government-approved insurance or pay a fine, and provide subsidies for individuals to purchase government-designed "private" insurance policies on government-run exchanges.

The truth is that most of the dysfunctions in our health-care system are the result of gravely flawed federal policies, and so long as those policies remain in place, no amount of experimentation by state governments can create a transparent, efficient, or patient-centered system. Federal policy strongly encourages third-party provision of health insurance, and penalizes its purchase by individuals, in two ways: It subsidizes employer-provided coverage through the tax code; and it grants states the authority to establish regulatory fiefdoms over individually purchased insurance, thus preventing the emergence of a national market. Thanks to these policies, individuals rarely own their insurance policies and rarely even know their true cost; nor do they often know the costs of medical services, or have much incentive to choose lower-cost options. Thus, costs spiral out of control.

Coulter, Levin, and Ponnuru all defend Romney by arguing that he was operating within the constraints of a distorted federal system. “There's not much governors can do about the collectivist mess Congress has made of health care in this country,” writes Coulter. But of course Obama was also operating within the confines of a distorted system, including many interest groups and voters deeply resistant to change.